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Simplified Approaches/Nutrition Protocols in emergency contexts

This question was posted the Simplified Approaches for the Management of Acute Malnutrition forum area and has 2 replies.

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Anonymous 16058

Consultant

Normal user

18 Jun 2021, 09:18

Quite alot of the research on the simplified nutrition protocols has been conducted in stable settings. Does anyone have experience of implementing these protocols in emergency contexts? What were your experiences and outcomes?

Mark Manary

Professor

Normal user

24 Jun 2021, 14:51

Use of community/ mother based MUAC is really not of harm to children, as it simply is a more objective way to to alert community members that malnutrtition treatment may be needed.  It does not commit any child to receiving food, the food dispensing agency remeasures the child, and make the final decision. So it is never contraindicated.  The effectiveness of the community/ mother based MUAC screening to actually help children is contingent upon the availablity of SAM treatment, is SAM treatment available almost every week of the year at an accesable location?  The truthful answer to this question in sub-Saharan Africa is largely 'no'. SAM treatment is intermittently available in many, many locations.  But stockouts rule the month.  Community members will quickly learn the limitations that stockouts impose.  If an implementing agency is considering community screening drives with health aids, they are likely to reach a more diverse population (more needy children) with community-based MUAC screening. Once weak supply chain problems are addressed, I fully recommend community/ mother based MUAC identification efforts.  

Pilar Charle Cuellar

Action against Hunger. iCCM adviser

Normal user

7 Jul 2021, 13:18

According to UNICEF, the treatment of acute malnutrition with CHWs is one of the simplified approaches. Action against Hunger is finalizing a study in the northern Mali region of Gao in an emergency context. I share the record of the study https://doi.org/10.1186/ISRCTN60973756  

It is an RCT with 3 branches: 1) control group: treatment of acute malnutrition with CMAM protocol at health facilities; 2) intervention group 1: treatment of acute malnutrition with CMAM protocol at health facilities and with community health workers; 3) intervention group 2: treatment of acute malnutrition with a combined protocol at health facilities and with community health workers.

We have finished the inclusion of the children in June, the preliminary results are very encouraging. We are confident to contribute evidence on how simplified approaches, and in particular the work of CHWs, is an effective solution to increase the coverage of SAM treatment in emergency settings.

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